Healthcare Provider Details

I. General information

NPI: 1336106962
Provider Name (Legal Business Name): EMILY BATSON D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 E CHEYENNE MOUNTAIN BLVD STE C
COLORADO SPRINGS CO
80906-4007
US

IV. Provider business mailing address

1580 E CHEYENNE MOUNTAIN BLVD STE C
COLORADO SPRINGS CO
80906-4007
US

V. Phone/Fax

Practice location:
  • Phone: 719-576-4247
  • Fax: 719-576-3070
Mailing address:
  • Phone: 719-576-4247
  • Fax: 719-576-3070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number8667
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number8667
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: